Orthopedic devices and methods of using the same



C. F. QUICK A ril 18, 1 967 ORTHOPEDIC DEVICES AND METHODS OF USING THE SAME 2 Sheets-Sheet 1 Filed Nov. 15, 1963 FIG. 2

A T T O R N E Y A ril 18, 1967 c. F. QUICK 3,314,419

ORTHOPEDIC DEVICES AND METHODS OF USING THE SAME v Filed Nov. 15, 1963 2 Sheets-Sheet 2 INVENTOR. CARL F. QUICK ATTORNEY United States Patent G 3,314,419 ORTHOPEDIC DEVICES AND METHODS OF USING THE SAME Carl F. Quick, St. Louis County, Mo. (11147 Pritchard Drive, St. Louis, Mo. 63136) Filed Nov. 15, 1963, Ser. No. 324,129 20 Claims. (Cl. 128-90) The present invention relates in general to certain new and useful improvements in orthopedic devices and, more particularly, to splints and methods for using the same.

In the treatment of fractured limbs, the orthopedic surgeon, or veterinarian, sets the fracture and then en cases the limb in a plaster cast which immobilizes the limb in the region of the fracture for a period of time in order to allow the bones to knit. In the case Olf bad sprains or torn ligaments, similar techniques are often employed. Actually, plaster casts are heavy, cumbersome, and difiicult to apply properly. For this reason, doctors prefer to avoid using plaster casts for sprains and torn ligaments except as a last resort. Of course, plaster casts cannot be avoided in the handling of fractures and the same problems of weight, bulkiness, and inconvenience are encountered. Moreover, a plaster cast very quickly becomes soiled and dirty in appearance, but it cannot readily be cleaned.

It is, therefore, the primary object of the present invention to provide novel means and methods for applying splints to bro-ken or damaged limbs of humans and animals.

It is another object of the present invention to provide means and methods of the type stated by which splinting can be carried out in a simple, and efiicient manner.

It is also an object of the present invention to provide means and methods of the type stated which are simple, economical, and can be utilized without highly specialized instruments, equipment, or surgical skills.

It is an additional object of the present invention to provide means and methods whereby fractured or otherwise injured lim-bs can be encased in a splint that is not only much stronger than conventional plaster casts, but also is considerately more comfortable and sanitary during use.

With the above and other objects in view, my invention resides in the novel features of form, construction, arrangement, and combination of parts presently described and pointed out in the claims.

In the accompanying drawings:

FIG. 1 is a fragmentary front view of a patient with a fractured lower arm encased in a splint constructed in accordance with and embodying the present invention;

FIG. 2 is a transverse sectional view taken along line 22 of FIG. 1;

FIG. 3 is a fragmentary side view of a patients ankle and foot encased in a splint constructed in accordance with and embodying the present invention;

FIG. 4 is a transverse sectional view taken along line 44 of FIG. 3;

FIG. 5 is a fragmentary front view of a patient with an injured elbow which is encased in a splint constructed in accordance with and embodying the present invention;

FIG. 6 is a fragmentary front view of a modified form of splint constructed in accordance with and embodying the present invention;

FIG. 7 is a fragmentary front view of a patient with a fractured arm encased in a third modified form of splint constructed in accordance with and embodying the present invention;

* 8--8 of FIG. 7; and

3,314,419 Patented Apr. 18, 1967 FIG. 9 is a perspective view of the third modified form of splint in opened-out position, prior to use.

Referring now in more detail and by reference characters to the drawings which illustrate practical embodiments of the present invention, 1 designates a surgical splint or so-called cast which is formed from an extruded synthetic resin tube having so-called heat-shrinkable properties. A number of synthetic resins such as solid polyolefin resins, polyvinylchloride resins, neoprene (polymerized chloroprene), tetrafluoroethylene resins, and polyorgano siloxane elastomers can be treated by various conventional methods so as to have heat-shrinkable properties. This is most commonly accomplished by irradiating the resin with a high-voltage electron ionizing discharge which, it is believed, produces cross-linkages Within the polymer so that the material can be expanded mechanically to some selected size or shape and wil l remain in this expanded position until subjected to heat. When heated, the material will shrink and return to the original size and shape and at the same time increase the number of cross-linkages so as to become more rigid. This property is sometimes referred to in the plastics industry as a memory. Many of these polymers have an inherent memory and do not require irradiation, but may simply be heated, expanded, and allowed to cool in the expanded position. When such polymers are again heated, they will return to their originalsize and shape. It is also known that in the case of many such co-polymers, heat-shrinkable properties can be obtained by treatment with organic peroxides.

It has been found, in connection with the present invention, that splints made of heat-shrinkable resins will not only shrink when heated, but possess a so-called memory which seems to extend from an indefinitely long period of time and, therefore, have a desirable degree ofshel-f-life. It has also been experimentally demon strated in connection with the present inventionthat the compressive forces generated by the resin during heatshrinkage are quite substantial in magnitude. Therefore, the splint must be made in predetermined sizes, and the size marked legibly on the surface, so that the surgeon can measure the perimeter of the arm or leg to which the splint is being applied and will not select one that will heat-shrink down to an unduly small size, thereby imposing undue constructional forces on the flesh and blood 'vessels.

The tubular splint 1 intended for the forearm A of an average male adult preferably consists of a frusto conical piece of extruded irradiated polyvinylchloride tubing having a length of approximately 10 in. Assuming that such forearm has an average perimetral size of 8 inches at the wrist and 11 inches at the thickest part, the tubing should have an original internal diametral size of 2.4 to 2.5 in. at the small end, and 3.3 to 3.4 in. at the large end, and a uniform Wall thickness of 7 in. Preferably, though not necessary, the piece of tubing is provided in its central region with a plurality of small apertures 2, for purposes presently more fully appearing. The piece of tubing is then heated to a temperature slightly above its crystalline melting point (i.e. a temperature within the range of F. to 350 F.), and, while being maintained at this elevated temperature, is expanded to an inside diametral, size of approximately 4 /2 in. at the small end and 6 in. at the large end. In affecting mechanical expansion, reasonable care should be observed to avoid causing any substantial change in the axial length of the piece of tubing. Immediately following the heat treatment, the piece of tubing is quenched 'while being mechanically held in its expanded condition, thereby forming the tubular splint 1. As a result of quenching,

usual orthopedic technique. board b of a conventional type made of rigid plastic or 'waterproof and rather firm in texture.

1 intended for a childs forearm, a different size should "be selected. For example, if the arm measures 2 in. in

diameter at the largest part, and 1 /2 in. at the Wrist, a

splint should be selected which was originally of these dimensions and of axial length to fit the length of the arm to be splinted.

The method of using the tubular splint 1 is diagrammatically illustrated in FIGS. 1 and 2. In carrying out this method, the patients arm A is manually reset by the An elongated 'arcuate splint metal is applied in an appropriate position. The splintboard b and arm A are then wrapped in a couple of turns of foamed plastic sponge sheeting, 3 so that the perimetral size is slightly greater than the size to which the splint 1 will shrink. The sheeting or bandage 3 is preferably made of close-cell dense foam so as to be substantially Preferably, a length of fine gauge piano wire w is laid lengthwise over the bandage 3 and twisted at its ends into gripping loops which extend beyond the upper and lower ends of the bandage 3. The tubular splint 1 is then loosely slipped over the arm A and manually shifted so that its axial position properly straddles the fracture. In this assembled relation, the arm A and tubular sprint 1 are placed between conventional heat-radiators (not shown), such as infra-red lamps, and gently heated. This temperature will not burn the patients flesh. Of course, other heating means may be employed. The maximum temperature on the patients skin, under the bandage 3, as recorded in tests, is approximately 140 F. Irrespective of the particular heating means employed, the tubular splint 1 should be held at this temperature for a period of approximately three minutes. During such period of time, and

while held in such temperature range, the tubular splint 1 will be somewhat pliable so as to conform itself readily to the contour and shape of the patients arm A and will shrink into snug tight contour-conformed engagement therewith, substantially as shown in FIG. 1. The apertures 2 not only provide ventilation, but also permit visual observationduring shrinkage, of the amount of shrinkage taking place. As soon as the foam begins to fill the apertures 2, the shrinking process may be stopped. Thereupon, the arm A, with the heat-shrunk tubular splint 1 in place, is removed from the heated zone and allowed to cool gradually at ordinary room temperature. Under such circumstances, the tubular splint 1 will return to the size which it possessed after original extrusion and will exert a firm, gentle, compressive force upon the flesh around the fracture. By reason of the fact that further polymerization takes place during heat-shrinkage, the tubular splint 1 will become stiff and rigid. The pressure applied to the fracture is peripherally uniform and the tubular splint 1 is Waterproof so the patient can take baths without special precaution, and the surfaces of the splint 1 can be washed whenever the splint 1 becomes soiled. To facilitate removal, one of the gripping loops 1 of the wire w can be restrained while the other is pulled outwardly and lengthwise, so as to cut the sleeve apart axially.

Tubular splints made of polyolefin such as polyethylene, polyvinylchloride, or synthetic elastomers such as neoprene, teflon, and siloxane resins, all in approximately the same dimensions above specified, have been found to produce similar satisfactory results. The temperature ranges to which such materials must be heated, vary somewhat, but the crystalline melting point in each case is wellknown and can be ascertained from the literature or by reference to the manufacture of such material. Actually,

it has been found desirable, in stretching the splints and in heat-shrinking them, to use a temeprature which is approximately 15 F. above the crystalline melting point.

It is also possible to provide a tubular splint 4 of the type shown in FIG. 3 which is of L-shaped configuration and has a corner-opening 5 for disposition around the ankle, heel and instep of a patients foot F. This splint 4 is initially molded in the L-shaped configuration from the previously mentioned materials and mechanically expanded as above described. The dimensional considerations are also substantially the same as above discussed. The tubular splint 4 may be used for sprained ankles or torn ankle-ligaments and is applied substantially in the same manner as described in connection with the tubular splint 1. The ankle is wrapped in a layer of plastic foam bandage 6 and the expanded splint 4 slipped into place. The tubular splint 4 is then heat-shrunk as previously described.

It is also possible to provide a tubular splint 7 as shown in FIG. 5, which is substantially the same as the tubular splint 4, except that it is adapted in size and shape,

to fit around a patients elbow E. Similarly, it is posin giving auxiliary support to limbs, where such support is needed.

It is also possible to provide a third modified form of splint 10, as shown in FIGS. 7 to 9 inclusive, comprising a tube of heat-shrinkable plastic material which has been mechanically expanded and then axially split to form an initially flat sheet 11. The opposite longitudinal margins of the sheet 11 are split or kerfed to form elongated narrow placket-flaps 12-12 and 1313 into which matchportions 14-15 of a conventional fully openable zipper are inserted and secured by lines of stitches 1616. The splint 10 can be folded around an injured limb which, for some reason, cannot be treated with an initially tubular splint. As a first step in the splinting operation, the injured limb can be wrapped in a suitable bandage 17, similar to the previously described bandages 3 or 6. The splint 10 is then zipped up so to speak, thereby restoring it to tubular form and heat-shrunk as previously described. The presence of the zipper elements 15-15' do not impair or interfere with the heat-shrinking properties of the material.

It should be understood that changes and modifications in the form, construction, arrangement, and combination of the several parts of the orthopedic devices and methods of using the same may be made and substituted for those herein shown and described without departing from the nature and principle of my invention.

-Having thus described my invention, what I claim and desire to secure by Letters Patent is:

1. The method of rigidly confining injured limbs, which method comprises forming a tubular element from a heatshrinkable synthetic resin, said tubular element being formed with an original internal peripheral size smaller than the outside peripheral size of the injured limb, expanding the tubular element diametrally to an internal peripheral size larger than the outside peripheral size of the injured limb, placing the expanded tubular element around the injured limb, and then heat-shrinking the tubular element down into snug-fitting embracing engagement around the injured limb.

2. The method of rigidly confining injured limbs, which method comprises forming a tubular element from a heatshrinkable synthetic resin, said tubular element being formed with an original internal peripheral size substantially smaller than the outside peripheral size of the injured limb, expanding the tubular element diametrally to an internal peripheral size larger than the outside peripheral size of the injured limb, placing the expanded tubular element around the injured limb, and then heat-shrinking the tubular element down into snug-fitting embracing engagement around the injured limb.

3. The method of rigidly confining injured limbs, which method comprises forming a tubular element from a heatshrinkable synthetic resin, said tubular element being formed with an original internal peripheral size smaller than the outside peripheral size of the injured limb, expanding the tubular element diametrally to an internal peripheral size larger than the outside peripheral size of the injured limb, while maintaining it at substantially the same axial length, placing the expanded tubular element around the injured limb, and then heat-shrinking the tubular element down into snug-fitting embracing engagement around the injured limb.

4. The method of rigidly confining injured limbs, which method comprises forming a tubular element from a heatshrinkable synthetic resin, said tubular element being formed with an original internal peripheral size smaller than the outside peripheral size of the injured limb, expanding the tubular element diametrallyto an internal peripheral size larger than the outside peripheral size of the injured limb, centering the tubular element lengthwise along the injured limb so as to span the injury and extend approximately equidistantly on opposite sides thereof, and then heat-shrinking the tubular element down into snug-fitting embracing engagement around the injured limb.

5. The method of rigidly confining injured limbs, which method comprises forming a tubular element from a heatshrinkable synthetic resin, said tubular element being formed with an original internal peripheral size smaller than the outside peripheral size of the injured limb, expanding the tubular element diametrally to an internal peripheral size larger than the outside peripheral size of the injured limb, wrapping the injured area of the limb in a compressible element, placing the expanded tubular element around the injured limb and compressible element, and then heat-shrinking the tubular element down into snug-fitting embracing engagement around the injured limb.

6. The method of rigidly confining injured limbs, which method comprises forming a tubular element from a heatshrinkable synthetic resin, said tubular element being formed with an original internal peripheral size smaller than the outside peripheral size of the injured limb, expanding the tubular element diametrally to an internal peripheral size larger than the outside peripheral size of the injured limb, wrapping the injured area of the limb in a compressible element, formed of a relatively thin section of foamed synthetic resin, placing the expanded tubular element around the injured limb and compressible element, and then heat-shrinking the tubular element down into snug-fitting embracing engagement around the injured limb.

7. The method of rigidly confining injured limbs, which method comprises forming a tubular element iirom a heatshrinkable synthetic resin, said tubular element being formed with an original internal peripheral size smaller than the outside peripheral size of the injured limb, expanding the tubular element diametrally to an internal peripheral size larger than the outside peripheral size of the injured limb, wrapping the injured area of the limb in a compressible element, formed of a relatively thin section of polyurethane foam, placing the expanded tubular element around the injured limb and compressible element, and then heat-shrinking the tubular element down into snug-fitting embracing engagemet around the injured limb.

8. The method of rigidly confining injured limbs, which method comprises forming a tubular element from a heatshrinkable synthetic resin, said tubular element being formed with an original internal peripheral size smaller than the outside peripheral size of the injured limb, expanding the tubular element diametrally to an internal peripheral size larger than the outside peripheral size of the injured limb, severing the expanded tubular element lengthwise, providing the severed edges with matching means by which the severed edges can be mechanically reconnected to bring the severed tubular element back to tubular form, placing the expanded tubular element around the injured limb, while in disconnected position, reconnecting it into tubular form, and then heat-shringing the tubular element down into snug-fitting embracing engagement around the injured limb.

9. The method of claim 8 in which the matching means is a disconnectable zipper.

10. The method of rigidly confining injured limbs, which method comprises forming a tubular element from a heat-shrinkable synthetic resin, of the class consisting of solid polyolefin resins, polyvinylchloride resins, neoprene, tetrafiuoroethylene resins, and polyorgano siloxane elastomers, said tubular element being formed with an original internal peripheral size smaller than the outside peripheral size of the injured limb, expanding the tubular element diametrally to an internal peripheral size larger than the outside peripheral size of the injured limb, placing the expanded tubular element around the injured limb, and then heat-shrinking the tubular element down into snug-fitting embracing engagement around the injured limb.

11. The method of rigidly confining injured limbs, which method comprises forming a tubular element from a heat-shrinkable synthetic resin, said tubular element being formed with an original internal peripheral size smaller than the outside peripheral size of the injured limb, expanding the tubular element diametrally by the application of heat and internal mechanical pressure, to an internal peripheral size larger than the outsideperipheral size of the injured limb, placing the expanded tubular element around the injured limb, and then heatsh'rinking the tubular element down into snug-fitting embracing engagement around the injured limb.

12. The method of rigidly confining injured limbs, which method comprises forming a tubular element from a heat-shrinkable synthetic resin, said tubular element being formed with an original internal peripheral size smaller than the outside peripheral size of the injured limb, expanding the tubular element diametrally by the application of heat and internal mechanical pressure, to an internal peripheral size larger than the outside peripheral size of the injured limb, chilling the expanded tubular element while holding it stretched so that it thereafter remains at the enlarged size at room temperature, placing the expanded tubular element around the injured limb, and then heat-shrinking the tubular element down into snug-fitting embracing engagement around the injured limb.

13. The method of claim 12 in which the tubular element is heat-shrunk by exposing it to an externally applied temperature substantially in the range of F. to 250 F.

14. A splint for injured limbs comprising a tubular element formed from heat-shrinkable polyorgano siloxane elastomers, said tubular element having an original internal perimetral size smaller than the outside perimetral size of the injured limb to which it is to be applied, said tubular element having been expanded to a size substantially larger than said injured limb, said tubular element having a non-stretchable cord-like element extending therethrough and projecting externally therefrom at least at one end so that said element can be grasped and pulled, whereby to sever the tubular element and facilitate removal.

15. A splint for injured limbs comprising a tubular element formed from heat-shrinkable polyorgano siloxane elastomers, said tubular element having an original inter- 7 nal perimetr-al size smaller than the outside perimetral size of the injured limb to which it is to be applied, said tubular element having been expanded to a size substan: tially-larger than said injured limb, said tubular element having a wire extending therethrough and projecting externally therefrom at least at one end so thatsaid wire can be grasped and pulled, whereby to sever the tubular element and facilitate removal. I

16. A splint for injured limbs comprising a tubular element formed from heat-shrinkable polyorgano siloxane elastomers, said tubular element having an original internal perimetral size smaller than the outside perimetral size of the injured limb to which it is to be applied, said tubular element having been expanded to a size substantially larger than said injured limb, said tubular element having a non-stretchable cord-like element extending axially therethrough and projecting externally therefrom at least at one end so that said element can be grasped and pulled, whereby to sever the tubular element and facilitate removal. 7

17. A splint forinjured limbs comprising a tubular element formed from heat-shrinkable polyrogano siloxane elastomers, said tubular element having an original internal perimetral size smaller than the outside perimetral size of the injured limb to which it is to be applied, said tubular element having been expanded to a size substantially larger than said injured limb, whereby it can be freely slipped telescopically over the injured limb, and a bandage disposed adjacent the interior wall of said tubular element.

18. A splint for injured limbs comprising a tubular element formed from heat-shrinkable polyrogano siloxane elastomers, said tubular element having an original internal perimetral size smaller than the outside perimetral size of the injured limb to which it is'to be applied, said tubular element having been expanded to a size substantially larger'than said injured limb, whereby it can be freely slipped telescopically over the injured limb, and a bandage disposed adjacent the interior wall of said tubular element, said bandage consisting of foamed synthetic '16Sl1'1. v

19. A splint for injured limbs comprising a tubular element formed from heat-shrinkable polyrogano siloxane elastomers, said tubular element having an original internal perimetral size smaller than the outside perimetral size of the injured limb to which it is to be applied, said tubular element having been expanded to a size substantially larger than said injured limb, in which said tubular element is bent into an L-shaped configuration so as to fit around the ankle and instep of a patients foot and which has an opening at the apex of the L-shape to accommod-ate the patients heel.

20. A splint for injured limbs comprising a tubular element formed from a heat-shrinkable synthetic resin, said tubular element having a plurality of apertures in the wall thereof, said tubular element having an original internal perimetral size smaller than the outside perimetral size of the injured limb to which it i to be applied, said tubular element having been expanded to. a size larger than said injured limb, said tubular element being rigid upon heat shrinking so as to support said injured limb. v

References Cited by the Examiner UNITED STATES PATENTS 2,027,962 1/ 1936 Currie. 2,533,609 12/ 1950 Nolan et a1; 2,759,475 8/1956 Van Swaay 128-9O 3,022,543 2/ 1962 Baird et al. 3,085,569 4/1963 Cook et al. 12891 FOREIGN PATENTS 702,121 1/ 1954 Great Britain.

ROBERT E. MORGAN, Acting Primary Examiner.

RICHARD A. GAUDE'I, Examiner.

J. WHINEY, Assistant Examiner. 

1. THE METHOD OF RIGIDLY CONFINING INJURED LIMBS, WHICH METHOD COMPRISES FORMING A TUBULAR ELEMENT FROM A HEATSHRINKABLE SYNTHETIC RESIN, SAID TUBULAR ELEMENT BEING FORMED WITH AN ORIGINAL INTERNAL PERIPHERAL SIZE SMALLER THAN THE OUTSIDE PERIPHERAL SIZE OF THE INJURED LIMB, EXPANDING THE TUBULAR ELEMENT DIAMETRALLY TO AN INTERNAL PERIPHERAL SIZE LARGER THAN THE OUTSIDE PERIPHERAL SIZE OF THE INJURED LIMB, PLACING THE EXPANDED TUBULAR ELEMENT AROUND THE INJURED LIMB, AND THEN HEAT-SHRINKING THE TUBULAR ELEMENT DOWN INTO SNUG-FITTING EMBRACING ENGAGEMENT AROUND THE INJURED LIMB. 